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by Carson-DeWitt R

Medications for Pneumonia

The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.
Community-acquired pneumonia is most often treated with macrolides, such as clarithromycin, azithromycin, or doxycycline. It may also be treated with fluoroquinolones, such as levofloxacin, moxifloxacin, or gatifloxacin.
Hospital-acquired pneumonia may need to be treated with a combination of antibiotics if infected with multidrug-resistant bacteria.

Prescription Medication

Antibiotics in General
Antibiotics work by killing bacteria or preventing them from growing and reproducing. The choice of antibiotic depends on the type of bacteria that is believed to be causing the infection. The way the antibiotic is administered (oral or IV) depends on how ill you are and whether you have any other medical conditions that put you at risk for severe infection or complications.
You must take every dose of an antibiotic, even when you're feeling better.
Antibiotics may cause allergic reactions in susceptible people. You should discontinue your medication and immediately contact your doctor if you experience:
  • Skin rash
  • Hives
  • Itching
  • Puffy face
  • Puffiness around the eyes
  • Difficulty breathing
Many antibiotics interact with other medications. To avoid any dangerous or uncomfortable drug interactions, tell your doctor about all other medications you are using.
Beta-lactam Antibiotics
Common names include:
  • Amoxicillin
  • Amoxicillin-clavulanate
  • Piperacillin-tazobactam
  • Cephalexin
  • Cefadroxil
  • Cefaclor
  • Cefuroxime
  • Cefpodoxime
  • Loracarbef
  • Cefditoren
  • Cefixime
  • Ceftibuten
  • Cefepime
  • Meropenem
  • Imipenem/cilastatin
Possible side effects include:
  • Diarrhea —Contact your doctor if it severe.
  • Nausea or vomiting.
  • Bleeding problems—You may notice easy bruising, increased bleeding, or spontaneous bleeding.
  • Some beta-lactam antibiotics interfere with oral contraceptives. Use another form of contraception while you are taking these medications.
  • Some cephalosporins should not be taken with alcohol. Check with your doctor.
  • Some beta-lactam antibiotics interfere with sugar levels in people with diabetes . Check with your doctor before you change your dose of insulin or other diabetes drugs.
Fluoroquinolone Antibiotics
Common names include:
  • Ciprofloxacin
  • Levofloxacin
  • Gemifloxacin
  • Gatifloxacin
  • Moxifloxacin
If you are taking antacids or sucralfate, do not take them within two hours of taking a fluoroquinolone. Take these medications with a full glass of water. They may be taken either on an empty stomach or with meals. Check with doctor before taking some of the quinolones if you are taking any medication for your heartbeat.
Possible side effects include:
  • Increased sensitivity to the sun
  • Lightheadedness
  • Inflamed, torn tendons
Macrolides
Common names include:
  • Erythromycin
  • Azithromycin
  • Clarithromycin
Possible side effects include:
  • Stomach cramps
  • Nausea
  • Vomiting
  • Diarrhea
Tetracyclines
Common names include:
  • Tetracycline
  • Doxycycline
  • Minocycline
Always take these medications with a full glass of water.
Possible side effects include:
  • Stomach cramps, burning
  • Diarrhea
  • Nausea
  • Vomiting
  • Tetracycline can cause discolored teeth in children
  • When pregnant women take tetracycline, their children may have discolored teeth
  • Increased sensitivity to the sun
  • Lightheadedness
  • Decreased effectiveness of oral contraceptive—Use another form of contraception while your are taking tetracyclines.
Trimethoprim-sulfamethoxazole
Common names include:
  • Co-trimoxazole
  • Bactrim
  • Septra
These medications are usually not prescribed for infants less than two months old. Elderly people have an increased risk of skin and bleeding problems with these medications, especially if they are using diuretics. Always take the medications with a full glass of water.
Possible side effects include:
  • Increased sensitivity to the sun
  • Itching
  • Skin rash
  • Nausea
  • Vomiting
  • Diarrhea
  • Stomach upset
Aminoglycosides
Common names include:
  • Gentamicin
  • Kanamycin
  • Tobramycin
  • Amikacin
Aminoglycosides are usually given through an IV.
Because aminoglycosides can affect the kidneys, hearing, balance, and muscles, be sure to tell your doctor if you already have conditions that affect those body systems. Depending on your condition, a different antibiotic may be chosen.
Possible side effects include:
  • Kidney problems
  • Hearing problems
  • Balance problems
  • Muscle weakness, especially in those who already have conditions like Parkinson’s disease or myasthenia gravis
  • Nausea
  • Vomiting
  • Numbness, tingling, burning sensations in face and/or mouth
  • Seizures
  • Muscle twitches
Lincosamide
Common names include: Clindamycin
Possible side effects include:
  • Stomach cramps
  • Nausea
  • Vomiting
  • Diarrhea
  • Rash
  • Itching
Glycopeptides
Common names include Vancomycin
Glycopeptides are usually given through an IV.
These drugs can be hard on the kidneys and on hearing and balance. Tell your doctor if you already have conditions that affect those body systems.
Oxazolidinones
Common names include: Linezolid
Possible side effects include:
  • Drop in white blood cells, which can increase your risk of infection
  • Drop in platelets, which can increase your risk of:
    • Bleeding
    • Easy bruising
    • Slow healing
  • High blood pressure , especially when taken with aged cheeses, smoked foods, beer, wine, or soy sauce
Antiviral medication
Medications developed for the treatment of different types of viral pneumonia include:
Antifungal Medication
Common names include:
  • Amphotericin B
  • Fluconazole
  • Itraconazole
  • Voriconazole
  • Flucytosine
Antifungal medications are available to fight fungal pneumonias. You must take every dose of an antifungal. Even if you’re feeling better, be sure to complete the course of medication recommended by your doctor.
Antifungal medications may cause allergic reactions in susceptible individuals. You should discontinue your medication and immediately contact your doctor if you experience:
  • Skin rash
  • Hives
  • Itching
  • Puffy face
  • Puffiness around eyes
  • Difficulty breathing
Many antifungal medications interact with other medications. Make sure your doctor knows about all other medications you are using to avoid any dangerous or uncomfortable drug interactions. Be sure that your doctor knows about any other medical conditions you may have.
Possible side effects include:
  • Increased sensitivity to the sun
  • Fever
  • Chills
  • Skin rash
  • Itching
  • Diarrhea
  • Nausea
  • Vomiting

Over-the-Counter Medication

Acetaminophen
Common brand name includes: Tylenol
Acetaminophen can be helpful in relieving some of the fever and pain associated with pneumonia. It’s also safe to give to children. Do not take larger doses than is recommended by your doctor. Do not drink alcoholic beverages while you are taking acetaminophen. Excess acetaminophen can be toxic to your liver.
Ibuprofen
Common brand names include:
  • Motrin
  • Advil
Ibuprofen can also help relieve some of the fever and discomfort associated with pneumonia. Ibuprofen may irritate the stomach; you should take this medication with food. Drinking alcoholic beverages while you are taking ibuprofen can increase the chance that it will irritate your stomach.
On rare occasions, people have allergic reactions to ibuprofen. If you notice a new skin rash, difficulty breathing, or puffiness or swelling in your face or around your eyes, stop taking ibuprofen and immediately contact your doctor.

Special Considerations

Whenever you are taking a prescription medication, take the following precautions:
  • Take them as directed—not more, not less, not at a different time.
  • Do not stop taking them without consulting your doctor.
  • Don’t share them with anyone else.
  • Ask what effects and side effects to expect. Report them to your doctor.
  • If you are taking more than one drug, even if it is over-the-counter, be sure to check with a physician or pharmacist about drug interactions.

References

Bjerre LM, Verheij TJ, et al. Antibiotic for community acquired pneumonia in adult outpatients. Cochrane Database Syst Rev. 2004;2:CD002109

Carratala J, Martin-Herrero JE, et al. Clinical experience in the management of community-acquired pneumonia: lessons from the use of fluoroquinolones. Clin Microbiol Infect. 2006;12:2-11

How is pneumonia treated? National Heart Lung Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/pnu/treatment.html. Updated March 1, 2011. Accessed February 14, 2014.

Kabra SK, Lodha R, et al. Antibiotics for community acquired pneumonia in children. Cochrane Database Syst Rev. 2006;3:CD004874

Pneumonia in adults. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 14, 2013. Accessed February 14, 2014.

Pneumonia in children. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 7, 2014. Accessed February 14, 2014.

Schmidt-Ioanas M, Lode H. Treatment of pneumonia in elderly patients. Expert Opin Pharmacother. 2006;7:499-507

11/21/2007 DynaMed's Systematic Literature Surveillance. http://www.ebscohost.com/dynamed: Yahar D, Paul M, Fraser A, Sarid N, Leibovi L. Efficacy and safety of cefepime: a systematic review and meta-analysis. Lancet Infect Dis. 2007;7:338-348.

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